Orthopedic appliance



Dec. 17, 1963 R. w. RICHMOND ORTHOPEDIC APPLIANCE Filed June '7, 1961United States Patent ()lilicev 3,114,358 Patented Dec. 17, 19 533,114,363 @RTHiEl-EDHC APPLKANCE Rey W. Richmond, 3405 SW. 90th Ave,Portiand, ()reg. Filed June '7, E61, Ser. No. 115,374 3 Claims. (til.123-87) This invention relates to orthopedic devices, and concerns moreparticularly an abduction device or appliance to be applied to the legsof a patient, for holding the legs in a laterally spread-apart position.

A congenital defect sometimes found in infants is a malformation of thehip socket where the upper leg bone and pelvis are joined together. Thehip socket is not sufficiently deep to permit full articulation of theupper leg or thigh bone, with the leg properly seated therein. A form oforthopedic therapy applied to correct such a condition is to spread thelegs of the infant apart, and hold them substantially immovable in thisspread-apart position for an extended period, of, for example, about sixmonths. During this time, cartilage material at the joint tends to growabout the joint with the formation of a stronger and deeper socket.Natural growth of the intent is accompanied with development of thecartilage and improvement in muscle tone, with the result that the thighbone ultimately is held in the pelvis in a true balland-socket typejoint, without the thigh bone having a tendency to slip from place.

Conventional practice has comprised making a rigid plaster cast for theinfant, with such cast encompassing the lower torso or trunk of thechild and with its legs in an abducted position. The use of such a casthas been accompanied with several disadvantages. These include the factthat the cast is diificul-t to put on and can be used only once. It isalso uncomfortable to the child. Very important, problems of sanitationare raised. The ordinary diaper cannot be used, and after a short periodof time, the cast is dirty and unsightly.

A general object of this invention is to provide a novel orthopedicdevice for the treatment of such congenital defects, which is easilyplaced in proper position on a child to hold its legs spread apart andimmovable, and is easily removed.

A somewhat related object is to provide an orthopedic appliance ordevice for holding a :childs legs abducted, which is readily removed topermit the changing of a diaper and can then be reused. As a result, farmore sanitary conditions of treatment may be maintained than previouslypossible.

More specifically, it is an object of the invention to provide a novelorthopedic device, which comprises a sheet of stiff and flexiblematerial, having an intermediate portion that supports the base of thebuttocks and the area between the legs of an infant with the legsabducted, and ends that extend up the front and back side of the infant,and that further includes on each side of said sheet leg-holding meansfor holding an infants legs immovable and in spread-apart position.

Another object is to provide an orthopedic device that comprises a sheetof material that is stiff and flexible, with ends in operative positionextending up the back and front side of a patient, where such ends areconnected by means extending over the shoulders of a patient to hold thedevice in. place.

Yet another object is to provide an orthopedic device having means forholding a patients legs spread apart where said means takes the form ofelongated portions of material that in operative position are wrappedaround the legs to hold them immovable, and to provide such a devicewhere the elongated portions of material are held in operative positionby detachable means.

A still further object is to provide an orthopedic device with aflexible sheet providing the support in the device and that furtherincludes a novel cushioning element easily removed from the flexiblesheet that provides the support.

The foregoing, as well as other objects and advantages, are attained bythe invention, and the same is described hereinbelow in conjunction withthe accompanying drawings, wherein:

FIG. 1 illustrates the orthopedic device or appliance in operativeposition, as it would look when placed on a child with the childs legsfitted therein and immovably supported in spread-apart position;

FIG. 2 illustrates the device in FIG. 1, with portions removed, and withthe device opened up and flattened out, and illustrating the side thatforms the outer side thereof in FIG. 1; and

FIG. 3 is a View, with portions removed, of the device flattened out asin FIG. 2, but showing the side that forms the inside of the device,with the device in operative position, as in FIG. 1.

Referring now to the drawings, and first of all with principal referenceto FIGS. 2 and 3, the device of the invention comprises a sheet offlexible material it having what, in operative position, are front andrear flap or end portions, indicated at 12 and 14, respectively. Joinedwith the lower margins of flap or end portions 12 and 14-, andconnecting them together, is a connecting or intermediate portion 16such connecting portion in the embodiment illustrated actually being anintegral part of the sheet from which flap portions l2, 14 are formed.

On each side of connecting portion 1'6, and joined along a side marginthereof with portion 16, is a web or portion of material indicated inthe drawings at 18 and 24 respectively. Again, in the embodiment shown,such webs of material are internal parts of the sheet from which theflap portions and connecting portion 16 are formed. Each web or portionof material includes a base portion, indicated for the two portions at18a, 2%, respectively, that in effect is an extension of connectingportion is, and a flap end, indicated at 1812, Zlib, respec tively, thatextends parallel to flap 1'2 and to one side of it, with the deviceopened up as in F168. 2 and 3. The flap ends, therefore, save for theirjoinder with base positions 18a, 26a are disconnected from the remainderof the sheet.

As will become apparent from the description below, during use of thedevice flap portions 12 and 14- are strapped in an upright position, andthe flap ends described are wrapped about upper portions of a patientslegs to hold them immovable. Thus, detachable means is provided forholding flap portions 12. and i4- upright and beside the trunk or torsoof a patient and with connecting portion 16 against the base of itsbuttocks and between its legs, and additional detachable means isprovided for securing the fiap ends in place about the legs.

Specifically, integral with Webs of material 18, 20, and extending inFIGS. 2 and 3 in a direction opposite the flap ends 131), Zdb, are apair of strap portions 26, 28. The ends of the strap portions haveadjustably mounted thereon snap fasteners 3d. These have sockets adaptedto be snapped over catches 32 mounted on webs of material 18, 20. Thestrap portions, snap fasteners and catches constitute the detachablemeans for holding the flap ends in place in operative position. Strapportions 34, 36 are riveted to flap portion 14, and mounted on strapportions 34, 36 are adjustable snap fasteners 38. These have socketsadapted to be snapped over catches 40 mounted on flap portion 12. Strapportions 34, 36 and the fasteners and catches associated therewithconstitute the detachable means for holding flap portions 12, 14 inplace.

To make connecting portion 16 and that part of the device that supportsthe base of a patients buttocks and legs somewhat stiffer, a sheet ofreinforcing material 42 is attached by rivets 44 over the inner side ofthe connecting portion (see FIG. 3). Preferably the ends of thisreenforcing sheet extend over base portions 18a, 20a of webs of material18, 20, as shown.

Completing the description of the construction of the device, acushioning element is indicated at 50. This comprises a sheet of fabric,with a body portion 50a that substantially covers connecting portion 16,and arm portions 52, 54 that may be folded over to form sleeves coveringflap ends 18b, 20b, respectively. Each portion is opened up to enableremoval of the cushioning element, by opening a snap fastener 56 (seeFIG. 2). With the arm portions folded over in the form of sleevescovering flap ends 18b, 20b, the cushioning element is held fromshifting upwardly in FIG. 2 relative to the sheet of flexible materialthat mounts the cushioning element. Cushioning element 50 also isprovided with a band of material 58 that extends over the outside ofsheet 10. The band is formed by slotting element 50 With a slot 60, suchslot being about as long as flap portion 14 is wide. Shoulder portions180, 200 of the webs of material 18, 20, by sticking out to either sideof the ends of slot 60, inhibit shifting of cushioning element 50 withrespect to sheet 10 downwardly in FIG. 2.

Apertures are provided in sheet 10 and reenforcing sheet 42 whereby aircan circulate through the cushioning element and more comfort isprovided the patient. These apertures are indicated at 62.

Reference is now made to FIG. 1, which shows the device in operativeposition, or as it would look holding the legs of an infant abducted. Insuch operative position, flap portion 12 forms the front and flapportion 14 the back of the device. Straps 34, 36 are in position toextend up over the shoulders of a child, and have their ends fastened tothe front flap portion. The straps are operable to hold connectingportion 16, and the reenforcing seat covering the inside of portion 16,snugly against the base of the buttocks of a child, and because of thewidth of the connecting portion, a childs legs are supported spreadlaterally apart. Flap ends 18b, 20b are wrapped around to form thesleeves for enveloping the upper extremities of a childs legs, and areheld in wrapped around position by strap portions 26, 28. In thiswrapped-around position, web portions 18, 2t) function as leg-holdingmeans or portions operable to hold a childs legs immovable. Thus,connecting portion 16 can be said to constittue a mounting of stiffmaterial connecting the two leg-holding means and supporting them in aposition where legs held thereby are held spread apart.

The orthopedic device has been found to give an unyielding type ofsupport entirely adequate in promoting the corrective growth required ina child. The device is relatively light and considerably morecomfortable for a child than the usual rigid plaster casts. Mostimportant, the device may easily be removed, washed and then reused, andso also may the cushioning element in the device be easily detached andreplaced. As a result, more sanitary treatment is possible.

The device is constructed to hold both legs abducted because it has beenfound that where only the malformed leg is placed in a spread-outposition hyperextension of the leg tends to occur.

I claim:

1. An orthopedic abduction device comprising a sheetlike body of stiffand flexible material having ends adapted to be placed over the back andfront of a patient, and an intermediate portion between said endsadapted to be placed between and support the legs of a patient; saidsheet-like body also having on each side of said intermediate portion aweb of material including a base portion joined to said intermediateportion and bounded by a shoulder that projects laterally outwardly toone side of the ends of said sheet-like body; each of said webs ofmaterial terminating in a flap end that projects away from the shoulderof the web; said flap ends being adapted to be wrapped around a patientsleg; and a cushioning element detachably mounted on said sheet-like bodyhaving a slot adjacent one margin thereof; said cushioning element beingmounted on said sheet-like body with one of said sheet ends projectingthrough said slot; said cushioning element including adjacent said slotan expanse of material that covers the inside of said intermediateportion of said body; said cushioning element having a pair ofspaced-apart sleeve portions joined to said expanse of material andopposite the margin having said slot; said sleeve portions fitting aboutthe flap ends on each side of said intermediate portion, one about eachflap end.

2. An orthopedic device comprising a sheet-like body of stiff andflexible material having ends adapted to be placed over the back andfront of a patient and an intermediate portion between said ends adaptedto be placed between a patients legs; said sheet-like body also havingon each side of said intermediate portion a web of material bounded by ashoulder that projects laterally outwardly to one side of the ends ofsaid sheet-like body; and a cushioning element detachably mounted onsaid sheet-like body; said cushioning element including an expanse ofmaterial covering the inside of said intermediate portion, and a bandportion extending over the outside of one of said ends of saidsheet-like body having end portions joined to said expanse of materialadjacent said shoulders; said band portion by reason of the joinder ofend portions thereof with said expanse of material defining a slotthrough which said one of said ends of said sheet-like body projects.

3. An orthopedic abduction device comprising a onepiece sheet of stiffand flexible material having front and rear flap portions adapted to beplaced over the front and back of a patient and an intermediate portionbetween said front and rear flap portions adapted to be placed betweenand support the legs of a patient with the legs spread laterally apart;said sheet also having, on each side of said intermediate portion, a webof material including a base portion joined to said intermediate portionand a flap end joined to the base portion that is otherwise disconnectedfrom the remainder of said sheet; each of said flap ends having a lengthsufiicient to enable it to be wrapped around the upper extremity of apatients leg and substantially meet the base portion of said web; meansfor holding each of said flap ends in operative position about the legsof a patient; a reinforcing sheet separate from the first-mentionedsheet extending over the inside of said intermediate portion and havingopposite margins adjacent said front and rear flap portions of saidfirst-mentioned sheet; means securing said reinforcing sheet to saidfirst-mentioned sheet including fasteners joining only portions of saidreinforcing sheet between said opposite margins to said first-mentionedsheet whereby said opposite margins of the reinforcing sheet are leftfree; and means for holding the front and rear flap portions of saidfirst-mentioned sheet on the torso of a patient.

References Cited in the file of this patent UNITED STATES PATENTS 2,93,984 Kerr May 10, 1960 2,955,594 Craig Oct. 11, 1960 ,8 2 Fuzere Dec.18, 1962 OTHER REFERENCES Frejka: Orthopaedic Appliances Atlas, V0 1, pg Fig. 728 (copy in Div. 55).

2. AN ORTHOPEDIC DEVICE COMPRISING A SHEET-LIKE BODY OF STIFF ANDFLEXIBLE MATERIAL HAVING ENDS ADAPTED TO BE PLACED OVER THE BACK ANDFRONT OF A PATIENT AND AN INTERMEDIATE PORTION BETWEEN SAID ENDS ADAPTEDTO BE PLACED BETWEEN A PATIENT''S LEGS; SAID SHEET-LIKE BODY ALSO HAVINGON EACH SIDE OF SAID INTERMEDIATE PORTION A WEB OF MATERIAL BOUNDED BY ASHOULDER THAT PROJECTS LATERALLY OUTWARDLY TO ONE SIDE OF THE ENDS OFSAID SHEET-LIKE BODY; AND A CUSHIONING ELEMENT DETACHABLY MOUNTED ONSAID SHEET-LIKE BODY; SAID CUSHIONING ELEMENT INCLUDING AN EXPANSE OFMATERIAL COVERING THE INSIDE OF SAID INTERMEDIATE PORTION, AND A BANDPORTION EXTENDING OVER THE OUTSIDE OF ONE OF SAID ENDS OF SAIDSHEET-LIKE BODY HAVING END PORTIONS JOINED TO SAID EXPANSE OF MATERIALADJACENT SAID SHOULDERS; SAID BAND PORTION BY REASON OF THE JOINDER OFEND PORTIONS THEREOF WITH SAID EXPANSE OF MATERIAL